wakepromoter

Wake-promoters, or wake-promoting agents, are medications that increase wakefulness and reduce daytime sleepiness by acting on brain systems involved in arousal. The term most often refers to prescription drugs such as modafinil, armodafinil, and pitolisant, though it can also describe other agents used to treat fatigue and sleepiness. The precise mechanisms vary by compound and are not fully understood; proposed actions include modulation of the orexin/hypocretin system, effects on histaminergic signaling, and alterations in dopaminergic and noradrenergic neurotransmission.

Modafinil and armodafinil are non-stimulant wake-promoting agents that influence multiple neural pathways. Pitolisant is a histamine H3 receptor antagonist/inverse agonist that increases histamine release in the brain. These drugs are used to manage excessive daytime sleepiness in conditions such as narcolepsy, shift work sleep disorder, and obstructive sleep apnea–hypopnea syndrome. They are generally considered to have lower abuse potential than classic stimulants, but may still cause dependence in susceptible individuals and can produce adverse effects.

Common side effects include headache, nausea, dry mouth, insomnia, anxiety, and elevated blood pressure or heart rate in some patients. Serious reactions are uncommon but can occur; prescribing is typically guided by regulatory approvals, patient health status, and potential drug interactions. Safety considerations include cardiovascular risk, pregnancy and lactation status, and comorbid sleep or psychiatric conditions.

Ongoing research explores additional wake-promoting compounds and refinements of existing agents, as well as a deeper understanding of their mechanisms. Wake-promoters provide therapeutic options for sleep-related daytime impairment, but effective use requires individualized assessment and monitoring.